Laboratoire Of Biochimie Medicale

Sotteville-lès-Rouen, France

Laboratoire Of Biochimie Medicale

Sotteville-lès-Rouen, France
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Watine J.,Laboratoire Of Biologie Polyvalente | Wils J.,University of Rouen | Augereau C.,Laboratoire Of Biochimie Medicale
Annales de biologie clinique | Year: 2017

Two clinical practice guidelines published in 2012 and in 2013 by the Haute autorité de santé (HAS) respectively entitled "Adult chronic kidney disease" (clinical pathway guidelines) and "Clinical utility of vitamin D measurements" (Health technology assessment) contradict each other on a notable point: in 2012 the HAS recommend to measure blood concentrations of vitamin D once a year in all patients with chronic kidney disease whereas in 2013 the HAS recommend to use this test only for the ambulatory follow-up of patients three months after kidney transplantation. This contradiction encouraged us to evaluate the methodological quality of these two guidelines with the help of the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument which is consensual at an international level, in particular at the WHO (World Health Organization) and at the European Union. At the end of this comparative evaluation this preliminary hypothesis might be proposed: a more rigorous development (AGREE domain n̊3) as well as a higher editorial independence (AGREE domain n̊6) in 2013 than in 2012 (scores respectively are 57% and 56% in 2013 versus 24% and 25% in 2012) ensure a higher validity to the 2013 recommendations than to the 2012 recommendations. However this hypothesis is weakened by the subjective intrinsic value of the AGREE tool, and by various methodological shortcomings in these two guidelines. Therefore we conclude, using the AGREE terminology, that the methods for developing those guidelines are too uncertain, above all in 2012, for recommending their use without modifications.


Duvillard L.,University of Burgundy | Duvillard L.,Laboratoire Of Biochimie Medicale | Florentin E.,University of Burgundy | Florentin E.,Laboratoire Of Biochimie Medicale | And 5 more authors.
Arteriosclerosis, Thrombosis, and Vascular Biology | Year: 2013

OBJECTIVE - : In vitro studies showed that insulin stimulates the production of apolipoprotein AI (apoAI). Thus, we hypothesized that chronic hyperinsulinemia could contribute to the increase in the production of high-density lipoprotein apoAI that is observed in metabolic syndrome. APPROACH AND RESULTS - : We performed an in vivo kinetic study with stable isotope in 7 patients with insulinoma who showed hyperinsulinemia but no insulin resistance, 8 patients with insulin resistance, and 16 controls. Insulinemia was 3.1× (P<0.01) higher in patients with insulinoma or insulin resistance than in controls in the fasting state and, respectively, 3.5× and 2.6× (P<0.05) higher in the fed state. The high-density lipoprotein apoAI pool size was smaller in patients with insulin resistance than in controls (49.3±5.4 versus 59.6±7.7 mg·kg; P<0.01), whereas both the high-density lipoprotein apoAI fractional catabolic rate and the high-density lipoprotein apoAI production rate were higher (0.30±0.07 versus 0.20±0.04 pool·d; P<0.0001 and 14.6±1.5 versus 11.5±1.9 mg·kg·d; P<0.01, respectively). In contrast, no significant difference was observed for these parameters between patients with insulinoma and controls. In patients with insulinoma, the apoAI pool size tended to be greater than in patients with insulin resistance (56.3±8.6 versus 49.3±5.4 mg·kg; P=0.078), whereas both the apoAI fractional catabolic rate and the production rate were lower (0.20±0.06 versus 0.30±0.07 pool·d; P<0.01 and 11.1±1.6 versus 14.6±1.5 mg·kg·d; P<0.01, respectively). The apoAI fractional catabolic rate was the only variable associated with the apoAI production rate in multivariate analysis and explained 80% of its variance. CONCLUSIONS - : Chronic endogenous hyperinsulinemia does not induce any increase in the apoAI production rate, which seems to be more dependent on the apoAI fractional catabolic rate. © 2013 American Heart Association, Inc.


Watine J.,Laboratoire Of Biologie Polyvalente | Watine J.,Paris Observatory | Wils J.,Paris Observatory | Wils J.,University of Rouen | And 2 more authors.
Journal of Clinical Epidemiology | Year: 2014

Objective To challenge the Grading of Recommendations Assessment, Development and Evaluation (GRADE) group to address the potential misconceptions about their approach to grading the strength of recommendations in clinical practice guidelines. Study Design and Setting Based on our own expertise of health care professionals trying to think in depth about, and using, guidelines, we have identified four such misconceptions. Results These potential misconceptions are: (1) evidence in medicine means factual or scientific evidence; (2) opinions are a subcategory of evidence; (3) the most important evidence is related to clinical benefits and harms; (4) being virtuous, and principled, does not particularly help in developing the best possible guidelines. Conclusion We call on the GRADE leadership to address all the above-mentioned misconceptions. These need explicit answers in their manuscript series. © 2014 Elsevier Inc. All rights reserved.


Lesueur C.,University of Rouen | Lesueur C.,Laboratoire Of Biochimie Medicale | Bole-Feysot C.,University of Rouen | Bekri S.,University of Rouen | And 6 more authors.
Biochimie | Year: 2012

In the intestine, NF-κB is the main transcription factor involved in the anti-inflammatory effect of glutamine and we previously demonstrated that glutamine via its conversion to glutamate diminished the p65 protein content in Caco-2/TC7 cell nuclei without affecting the stimulating effect of IL-1β on NF-κB [21]. However, the molecular mechanism by which glutamine acts is not established. We therefore tried to identify such a mechanism. Our results demonstrate that glutamine decreased the intracellular NF-κB through the nuclear ubiquitin-proteasome pathway requiring therefore the nuclear translocation of the factor. Indeed, time-course study revealed that glutamine induced an increase in the nuclear p65 content within the first 15 min of culture, the p65 nuclear and cytosolic content decreasing gradually thereafter to reach 50 % of the control value after 60 min. This translocation was initiated by the phosphorylation of IκBα by the IKKβ subunit inducing its degradation and the p65 translocation. In parallel, glutamine activated the IKKα subunit which in turn phosphorylates p65 at Ser 536 which was responsible for p65 degradation by the nuclear proteasome. We also demonstrate that p38 MAPK lies between glutamine and the NF-κB pathway. In conclusion, this study identified for the first time the signaling pathway by which glutamine may protect against inflammatory conditions. © 2011 Elsevier Masson SAS. All rights reserved.


Attig L.,French Institute of Health and Medical Research | Vige A.,French Institute of Health and Medical Research | Gabory A.,French Institute of Health and Medical Research | Karimi M.,Karolinska Institutet | And 8 more authors.
PLoS ONE | Year: 2013

According to the developmental origins of health and diseases (DOHaD), and in line with the findings of many studies, obesity during pregnancy is clearly a threat to the health and well-being of the offspring, later in adulthood. We previously showed that 20% of male and female inbred mice can cope with the obesogenic effects of a high-fat diet (HFD) for 20 weeks after weaning, remaining lean. However the feeding of a control diet (CD) to DIO mice during the periconceptional/gestation/lactation period led to a pronounced sex-specific shift (17% to 43%) from susceptibility to resistance to HFD, in the female offspring only. Our aim in this study was to determine how, in the context of maternal obesity and T2D, a CD could increase resistance on female fetuses. Transcriptional analyses were carried out with a custom-built mouse liver microarray and by quantitative RT-PCR for muscle and adipose tissue. Both global DNA methylation and levels of pertinent histone marks were assessed by LUMA and western blotting, and the expression of 15 relevant genes encoding chromatin-modifying enzymes was analyzed in tissues presenting global epigenetic changes. Resistance was associated with an enhancement of hepatic pathways protecting against steatosis, the unexpected upregulation of neurotransmission-related genes and the modulation of a vast imprinted gene network. Adipose tissue displayed a pronounced dysregulation of gene expression, with an upregulation of genes involved in lipid storage and adipocyte hypertrophy or hyperplasia in obese mice born to lean and obese mothers, respectively. Global DNA methylation, several histone marks and key epigenetic regulators were also altered. Whether they were themselves lean (resistant) or obese (sensitive), the offspring of lean and obese mice clearly differed in terms of several metabolic features and epigenetic marks suggesting that the effects of a HFD depend on the leanness or obesity of the mother. © 2013 Attig et al.


Direct and indirect ion selective electrodes (ISEs) are two methods commonly used in biochemistry laboratories in order to measure the electrolytes such as sodium. In the clinical practice, it's the sodium concentration in plasma water -measured by direct ISE- which is important to consider as it is responsible of water movements between the liquid compartments. Knowing the difference between the two methods is important because there are situations leading to conflicting results between direct and indirect ISE, especially with sodium and inappropriate therapeutic decisions could be taken if the clinician is not aware of this difference. The increase and the decrease in plasma water volume are the situations that distort the results of the indirect ISE because this method, after a dilution step, does not take into account the real percentage of plasma water of the patient in the determination of the concentrations (leading for sodium to pseudohyponatremia, pseudonormonatremia or pseudohypernatremia). In the direct ISE, the sample is not diluted and the results are correct even if the volume of plasma water is modified. This article specifies the differences between the two techniques through a case of Waldenström's macroglobulinemia and proposes a course of action to follow for both of the biologist and the clinician. © 2015, John Libbey Eurotext. All rights reserved.


Nourrisson C.,Laboratoire Of Biochimie Medicale | Batisse M.,Service dEndocrinologie diabetologie maladies Metaboliques | Sapin V.,Laboratoire Of Biochimie Medicale | Bouvier D.,Laboratoire Of Biochimie Medicale
Annales de Biologie Clinique | Year: 2010

Mrs B., 39 years old, hospitalized in the department of respiratory medicine for lung cancer, has an undetectable and verified venous blood glucose concentration (measured in central laboratory) less than 0.1 mmol/L. The patient fells no symptom of hypoglycemia. A concomitant capillary determination realised by a bedside glucose reader gives a result of 4.7 mmol/L. This gap is due to glucose consumption in vitro by leukocytes between the time of sampling and laboratory analysis. Indeed the leukocyte count is 86.4 G/L (92% neutrophils) probably in a context of paraneoplastic syndrome. An efficient talk between biologist and clinician identified this phenomenon for this patient. This event allows us to recall the different causes of hypoglycemia (artifactual or real), and to describe the care of patients with true hypoglycemia.


Gouri A.,Laboratoire Of Biochimie Medicale | Dekaken A.,Service de Medecine Interne
Annales de Biologie Clinique | Year: 2012

Aberrations in calcium homeostasis are common observed in patients with chronic renal failure. Measure of total calcium does not reflect the real variation of the calcium status. The proper method to evaluate this issue in hemodialysis patients has not been completely defined. This study aimed to compare the corrected serum calcium levels to ionized calcium levels in hemodialysis patients. Thirty one patients on chronic haemodialysis admitted at the hemodialysis department were retrospectively reviewed. Calcium status was evaluated by measure of ionized levels and as a function of serum calcium levels corrected for albumin aberrations. Based on the measurement of ionized calcium and total calcium corrected, patients were classified into three categories: hypocalcemic, normocalcemic and hypercalcemic. Our result showed that the corrected serum calcium values failed to accurately classify calcium status in 41% of cases. The sensitivity and specificity of the corrected serum calcium formula to evaluate hypocalcemia were 53% and 85%, respectively. Corrected serum values underestimated the prevalence of hypocalcemia and overestimated the prevalence of normocalcemia. In total, the results obtained allow to conclude the lack of interest in the use of correction formulas. Calcium homeostasis should be evaluated by ionized calcium levels rather than as a function of serum calcium and albumin.


PubMed | Laboratoire Of Biochimie Medicale, Laboratoire Of Biologie Polyvalente and University of Rouen
Type: Journal Article | Journal: Annales de biologie clinique | Year: 2017

Two clinical practice guidelines published in 2012 and in 2013 by the Haute autorit de sant (HAS) respectively entitled Adult chronic kidney disease (clinical pathway guidelines) and Clinical utility of vitamin D measurements (Health technology assessment) contradict each other on a notable point: in 2012 the HAS recommend to measure blood concentrations of vitamin D once a year in all patients with chronic kidney disease whereas in 2013 the HAS recommend to use this test only for the ambulatory follow-up of patients three months after kidney transplantation. This contradiction encouraged us to evaluate the methodological quality of these two guidelines with the help of the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument which is consensual at an international level, in particular at the WHO (World Health Organization) and at the European Union. At the end of this comparative evaluation this preliminary hypothesis might be proposed: a more rigorous development (AGREE domain n3) as well as a higher editorial independence (AGREE domain n6) in 2013 than in 2012 (scores respectively are 57% and 56% in 2013 versus 24% and 25% in 2012) ensure a higher validity to the 2013 recommendations than to the 2012 recommendations. However this hypothesis is weakened by the subjective intrinsic value of the AGREE tool, and by various methodological shortcomings in these two guidelines. Therefore we conclude, using the AGREE terminology, that the methods for developing those guidelines are too uncertain, above all in 2012, for recommending their use without modifications.


PubMed | Laboratoire Of Biochimie Medicale
Type: Case Reports | Journal: Annales de biologie clinique | Year: 2015

Direct and indirect ion selective electrodes (ISEs) are two methods commonly used in biochemistry laboratories in order to measure the electrolytes such as sodium. In the clinical practice, its the sodium concentration in plasma water -measured by direct ISE- which is important to consider as it is responsible of water movements between the liquid compartments. Knowing the difference between the two methods is important because there are situations leading to conflicting results between direct and indirect ISE, especially with sodium and inappropriate therapeutic decisions could be taken if the clinician is not aware of this difference. The increase and the decrease in plasma water volume are the situations that distort the results of the indirect ISE because this method, after a dilution step, does not take into account the real percentage of plasma water of the patient in the determination of the concentrations (leading for sodium to pseudohyponatremia, pseudonormonatremia or pseudohypernatremia). In the direct ISE, the sample is not diluted and the results are correct even if the volume of plasma water is modified. This article specifies the differences between the two techniques through a case of Waldenstrms macroglobulinemia and proposes a course of action to follow for both of the biologist and the clinician.

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